scholarly journals Retinal venular tortuosity and fractal dimension predict incident retinopathy in adults with type 2 diabetes: the Edinburgh Type 2 Diabetes Study

Diabetologia ◽  
2021 ◽  
Author(s):  
Rachel B. Forster ◽  
◽  
Emmanuel Sandoval Garcia ◽  
Anniek J. Sluiman ◽  
Sheila M. Grecian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Fractal Dimension ◽  
Statistical Significance ◽  
Fractal Dimensions ◽  
Retinal Vessel ◽  
Related Factors ◽  
Discriminative Ability

Abstract Aims/hypothesis Our aim was to determine whether a range of prespecified retinal vessel traits were associated with incident diabetic retinopathy in adults with type 2 diabetes. Methods In the prospective observational cohort Edinburgh Type 2 Diabetes Study of 1066 adults with type 2 diabetes, aged 60–75 years at recruitment, 718 were free from diabetic retinopathy at baseline. Baseline retinal traits including vessel widths, tortuosity (curvature) and fractal dimensions (network complexity), were quantified using fundus camera images and semiautomated software, and analysed using logistic regression for their association with incident diabetic retinopathy over 10 years. Results The incidence of diabetic retinopathy was 11.4% (n = 82) over 10 years. After adjustment for a range of vascular and diabetes-related risk factors, both increased venular tortuosity (OR 1.51; 95% CI 1.15, 1.98; p = 0.003) and decreased fractal dimension (OR 0.75; 95% CI 0.58, 0.96; p = 0.025) were associated with incident retinopathy. There was no evidence of an association with arterial tortuosity, and associations between measurements of vessel widths and retinopathy lost statistical significance after adjustment for diabetes-related factors and vascular disease. Adding venular tortuosity to a model including established risk factors for diabetic retinopathy (HbA1c, BP and kidney function) improved the discriminative ability (C statistic increased from 0.624 to 0.640, p = 0.013), but no such benefit was found with fractal dimension. Conclusions/interpretation Increased retinal venular tortuosity and decreased fractal dimension are associated with incident diabetic retinopathy, independent of classical risk factors. There is some evidence that venular tortuosity may be a useful biomarker to improve the predictive ability of models based on established retinopathy risk factors, and its inclusion in further risk prediction modelling is warranted. Graphical abstract

scholarly journals Retinal arteriolar tortuosity and fractal dimension are associated with long-term cardiovascular outcomes in people with type 2 diabetes

Diabetologia ◽  
2021 ◽  
Author(s):  
Emmanuel Sandoval-Garcia ◽  
Stela McLachlan ◽  
Anna H. Price ◽  
Thomas J. MacGillivray ◽  
Mark W. J. Strachan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Fractal Dimension ◽  
Cardiovascular Risk ◽  
Cardiovascular Events ◽  
Statistical Significance ◽  
Retinal Vasculature ◽  
Cerebrovascular Events

Abstract Aims/hypothesis Our aim was to determine whether quantitative retinal traits in people with type 2 diabetes are independently associated with incident major cardiovascular events including CHD and stroke. Methods A total of 1066 men and women with type 2 diabetes, aged 65–74 years, were followed up over 8 years in the population-based Edinburgh Type 2 Diabetes Study. Using retinal photographs taken at baseline and specialist software, a number of quantitative retinal traits were measured, including arteriolar and venular widths and tortuosity as well as fractal dimension (a measure of the branching pattern complexity of the retinal vasculature network). Incident CHD events occurring during follow-up included fatal and non-fatal myocardial infarction, first episodes of angina and coronary interventions for CHD. Incident cerebrovascular events included fatal and non-fatal stroke or transient ischaemic attack. Cox proportional hazard regression analyses were performed to identify the association of the retinal traits with cardiovascular events in the population with retinal data available (n = 1028). Results A total of 200 participants had an incident cardiovascular event (139 CHD and 61 cerebrovascular events). Following adjustment for age and sex, arteriolar tortuosity and fractal dimension were associated with cerebrovascular events (HR 1.27 [95% CI 1.02, 1.58] and HR 0.74 [95% CI 0.57, 0.95], respectively), including with stroke alone (HR 1.30 [95% CI 1.01, 1.66] and HR 0.73 [95% CI 0.56, 0.97], respectively). These associations persisted after further adjustment for established cardiovascular risk factors (HR 1.26 [95% CI 1.01, 1.58] and HR 0.73 [95% CI 0.56, 0.94], respectively). Associations generally reduced in strength after a final adjustment for the presence of diabetic retinopathy, but the association of fractal dimension with incident cerebrovascular events and stroke retained statistical significance (HR 0.73 [95% CI 0.57, 0.95] and HR 0.72 [95% CI 0.54, 0.97], respectively). Associations of retinal traits with CHD were generally weak and showed no evidence of statistical significance. Conclusions/interpretation Arteriolar tortuosity and fractal dimension were associated with incident cerebrovascular events, independent of a wide range of traditional cardiovascular risk factors including diabetic retinopathy. These findings suggest potential for measurements of early retinal vasculature change to aid in the identification of people with type 2 diabetes who are at increased risk from stroke. Graphical abstract

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

scholarly journals Vascular endothelial growth factor (VEGF)-related polymorphisms rs10738760 and rs6921438 are not risk factors for proliferative diabetic retinopathy (PDR) in patients with type 2 diabetes mellitus (T2DM)

2019 ◽  
Vol 19 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Jana Sajovic ◽  
Ines Cilenšek ◽  
Sara Mankoč ◽  
Špela Tajnšek ◽  
Tanja Kunej ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vascular Endothelial Growth Factor ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor

Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and has been investigated as a candidate gene in a number of conditions, including diabetes and its microvascular complications (e.g., retinopathy and nephropathy). Several VEGF-related polymorphisms have been shown to contribute to nearly half of the variability in circulating VEGF levels in healthy individuals. Our aim was to assess the association between VEGF-related rs10738760 and rs6921438 polymorphisms and proliferative diabetic retinopathy (PDR) in Slovenian patients with type 2 diabetes mellitus (T2DM). We also investigated the effect of these polymorphisms on VEGF receptor 2 (VEGFR-2) expression in fibrovascular membranes (FVMs) from patients with PDR. This case-control study enrolled 505 unrelated patients with T2DM: 143 diabetic patients with PDR as a study group, and 362 patients with T2DM of >10 years duration and with no clinical signs of PDR as a control group. Patient clinical and laboratory data were obtained from their medical records. rs10738760 and rs6921438 polymorphisms were genotyped using TaqMan SNP Genotyping assay. VEGFR-2 expression was assessed by immunohistochemistry in 20 FVMs from patients with PDR, and numerical areal density of VEGFR-2-positive cells was calculated. The occurrence of PDR was 1.7 times higher in diabetic patients carrying GA genotype of rs6921438 compared to patients with GG genotype, with a borderline statistical significance (OR = 1.7, 95% CI = 1.00 – 2.86, p = 0.05). In addition, A allele of rs6921438 was associated with increased VEGFR-2 expression in FVMs from PDR patients. However, we observed no association between AA genotype of rs6921438 nor between rs10738760 variants and PDR, indicating that the two polymorphisms are not genetic risk factors for PDR.

scholarly journals Differences in Risk Factors for Diabetic Retinopathy in Type 1 and Type 2 Diabetes Mellitus Patients in North-East Poland

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 177
Author(s):  
Wojciech Matuszewski ◽  
Magdalena M. Stefanowicz-Rutkowska ◽  
Magdalena Szychlińska ◽  
Elżbieta Bandurska-Stankiewicz
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Study Group

Background and Objective: Nowadays, diabetes is one of the main causes of blindness in the world. Identification and differentiation of risk factors for diabetic retinopathy depending on the type of diabetes gives us the opportunity to fight and prevent this complication. Aim of the research: To assess differences in the risk factors for diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in Warmia and Mazury Region, Poland. Materials and Methods: Risk factors for diabetic retinopathy (DR) were assessed on the basis of an original questionnaire, which included: personal data, clinical history of diabetes and eye disease. Elements of clinical examination: blood pressure, BMI, waist circumference. Indicators of diabetes metabolic control: mean glycemia, glycated hemoglobin (HbA1c), total cholesterol and triglycerides, creatinine, glomerular filtration rate (GFR), albumin–creatinine ratio in urine. Results: The study group included 315 (26%) patients with DM1 and 894 (74%) patients with DM2. Risk factors were estimated on the basis of logistic regression and verified with Student’s t-test. Statistically significant dependencies were found in both groups between the occurrence of diabetic retinopathy and diabetes duration, HbA1c, triglyceride concentrations, indicators of kidney function and cigarette smoking status. In the DM2 group, the development of DR was significantly influenced by the implemented models of diabetic treatment. Conclusions: In the whole study group, the risk of DR was associated with the duration of diabetes, HbA1c, triglyceride concentrations and smoking. In DM1 patients, the risk of DR was associated with diabetic kidney disease in the G1A1/A2 stage of chronic kidney disease, and in DM2 patients with the G2 stage of chronic kidney disease. An important risk factor for DR in DM2 patients was associated with late introduction of insulin therapy.

Related Risk Factors between Subclinical Carotid Atherosclerosis and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetes Mellitus in China

2019 ◽  
Author(s):  
Fengqi Guo ◽  
Ting Zhou ◽  
Juan Tang ◽  
Mingxia Dong ◽  
Qianping Wei
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Subclinical Atherosclerosis ◽  
Vascular Diseases ◽  
Newly Diagnosed ◽  
Related Risk

Abstract Purpose To analyze the clinical features and related risk factors in diabetic retinopathy (DR) and subclinical atherosclerosis, the micro- and macro-vascular diseases in newly diagnosed type 2 diabetes mellitus (T2DM). Methods A retrospective study of 435 cases of inpatients with newly diagnosed T2DM from 2013–2017, and compare the 2 types of T2DM related vascular complications. Results The macro- and microvascular complications are not rare at this stage. Subclinical atherosclerosis was found in 251 subjects (57.7%), which was higher than that of DR (13.1%). In addition, some cases of subclinical atherosclerosis co-existed with DR, suggesting that DR was related with subclinical atherosclerosis (r=0.098, P=0.041). Older age showed a significant association with both subclinical atherosclerosis and DR. Single factor analysis indicated that dyslipidemia was the common risk factor in DR and subclinical atherosclerosis. Conclusions It should be paid attention to the screening of both DR and subclinical atherosclerosis in each age group of newly diagnosed T2DM. Except for the control of blood glucose, the control of the dyslipidemia is important in the prevention and treatment of the micro- and macro-vascular diseases.

scholarly journals Incidence and Risk Factors for Developing Diabetic Retinopathy among Youths with Type 1 or Type 2 Diabetes throughout the United States

Ophthalmology ◽  
2017 ◽  
Vol 124 (4) ◽  
pp. 424-430 ◽  
Author(s):  
Sophia Y. Wang ◽  
Chris A. Andrews ◽  
William H. Herman ◽  
Thomas W. Gardner ◽  
Joshua D. Stein
Keyword(s):  
United States ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
The United States
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